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The way we can take care of all our patients, but especially patients who are really sick, who need real doctors, while we are learning: layers. There is a team taking care of every patient “I” see. There’s a chief resident above me, there’s an attending above her. I talk to my chief and my attending about my patients. Sometimes I ask if I should do what I think I should do, sometimes I tell them what I’m doing. Often I am confirming what I know and they are refining my understanding. This is all information the front of my brain knows.
The inside of my brain, however, is pretty heartbroken today. It thinks that learning medicine is pretty shitty when you have to almost kill someone to learn things. My basic instinct brain thinks I’m essentially an attempted murderer. Today has been a hard day.
The truth is, I didn’t miss something. I really don’t think so at least. I think one of my patients had early symptoms that resolved while I was caring for her and then acutely had some really bad shit go down. Women really do die after having babies. It’s a thing.
She didn’t die but she was and is very unwell. There are implications for the rest of her life. I didn’t miss it when I saw her yesterday afternoon, because it wasn’t there yet. But this morning she was whisked away from our care and sent to the intensivists, to the ICU, where they will hopefully stabilize her.
I will never ever forget this constellation of symptoms and circumstances and I will work hard to catch it sooner next time. If it could even be caught any sooner. It is quite possible that the complications were caught as soon as there was something to catch, that her body was hiding the problem even from trained eyes, that there was no telling that she was going to go into that level of distress based on any information we had at our disposal before she actually crashed.
I can’t save everyone. Today I am confronted with that reality and it hurts.
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Today I delivered a baby that weighed a pound and a half.
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After work today I was too keyed up to go straight to the Mom Duties that await me. It was also warm enough to consider a swim so I invited the kids to join me and my daughter and I went for a quick dip. When you have a pool at your immediate disposal, you use it differently than how I used to think about going to the pool. It can be a quick 15 minute dip, floating in the water, staring at the sky, or maybe swimming a few laps to get some pent up energy out or practicing cannonballs and somersaults. Then you just head home, take a shower and make breakfast burritos for dinner. Onward and upward!
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Today I delivered a baby that was alive yesterday.
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My son made dinner tonight. Wouldn’t let me into the house when I got home (our main door is through the kitchen) so I sat outside on the porch with my feet up and listened to music. And had a delicious dinner delivered to me! Don’t let anyone tell you that raising boys is easy or that young men have simple emotional lives. This kid contains multitudes and he’s amazing.
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One of my children or the other has lost their temper three times now and and damaged a piece of my home. All the pieces are repairable, but it is still a huge pain in the ass. They need to reign in their tempers a little bit. At least the latest one is an easy replacement part (door shelf on the fridge) and I can charge Little Hothead for it. Good thing they made all that money this summer!
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